Blood aspiration assembly components and blunt needle aspirators

ABSTRACT

A blood aspiration assembly and method has proximal, intermediate and distal tubing, an adjustable volume reservoir and an aspirator receiver. The receiver has a housing with a rigid casing and a resilient plug, and a liquid flow chamber. The resilient plug has a slit or perforation to allow passage of a blunt needle therethrough. The plug can have two parts of different compliance, which aligned slits or perforations. The blunt needle tip can be rounded or flat, with a side opening for the needle bore. The contour of the needle tip and the design of the plug are correlated such that the working force required to penetrate the needle tip into the plug perforation is considerably less than the force required for said needle tip to penetrate normal intact human skin of the hands or arms.

This is a division of application Ser. No. 07/594,677, filed Oct. 10,1990, now U.S. Pat. No. 5,178,607 which was a continuation ofapplication Ser. No. 302,835, filed Jan. 27, 1989, abandoned, which wasa continuation in part of application Ser. No. 07/080,406, filed Jul.31, 1987 now U.S. Pat. No. 4,838,855 abandoned.

BACKGROUND AND SUMMARY OF THE INVENTION

This invention relates to human blood aspiration assemblies and methodsof their use. It is necessary and indeed critical to frequently drawblood from patients having a broad variety of illnesses. Cumulative andrepetitive blood sampling must be conducted in a number of instances.Such blood samples are often drawn through tubing systems that areconnected to indwelling catheters to avoid the pain, inconvenience andpotential complications of frequent penetration of the patient's skin.

These tubing systems are often maintained in near-constant direct fluidcommunication with the vasculature through the catheter, and are usedfor monitoring pressures within the vasculature, for fluidadministration, or simply for maintaining a channel for easy access tothe vascular system.

These tubing systems generally contain an electrolyte or dextrosesolution when in fluid connection with the vasculature. The reflux ofblood into such tubing systems is prevented by maintaining fluidpressure within such tubing equal to, or higher than, that in the vesselin which the catheter dwells. This pressure avoids thrombotic occlusionof the tubing system or catheter while allowing the system to remainpatent, or unobstructed despite near constant fluid communication withthe vascular system.

In the prior art, such an above-described system can have a proximaltubing segment portion which is closest to the high pressure source, adistal tubing segment which is closer to the catheter, and a channelwhich opens to the atmosphere (atmospheric channel). This channel isusually capped. A three-way stopcock is connected to the channel and isin line with the tubing. Normally the stopcock connects the proximaltubing to the distal tubing, with the atmospheric channel closed.

When a blood sample is desired, the cap covering the atmospheric channelis removed. A separate syringe is moved by the hand and its neckconnected to the atmospheric channel. The stopcock is then turned toopen the distal tubing to the syringe. This places the vascular systemin direct fluid communication with the syringe. Fluid can then beaspirated from the tubing and the vascular system into the syringe. Uponaspiration, the initial liquid entering the syringe is the residentfluid in the distal tubing segment.

After this, blood, diluted with such resident fluid, will enter thesyringe. Finally, after all the resident fluid has been aspirated intothe syringe, undiluted blood will enter the syringe and will entirelyfill the distal tubing. The stopcock is then closed to the atmosphericchannel, and the first syringe is detached from the stopcock. The firstsyringe is in many uses discarded. With premature infants or smallbabies, the diluted blood in the first syringe may be reinjected afterthe blood sample for testing is obtained. But there is a risk of clotformation, thrombosis or infection when this attempt to save blood ismade.

A second syringe then must be attached to the atmospheric channel andthe stopcock is reopened to the second syringe to thereby place thesyringe in fluid communication with the distal tubing that is filledwith undiluted blood.

Undiluted blood is then aspirated into the second syringe from thedistal tubing and the vasculature in the amount desired for analysis.When sufficient blood is obtained, the stopcock is closed to the secondsyringe. The second syringe is removed. At this point in some cases, tosave blood, the diluted blood is reinjected from the first syringe backinto the stopcock with the aforesaid hazards of thrombosis, clotting andinfection. The stopcock is thence commonly closed to the distal tubingand opened to produce liquid communication between the proximal tubingand the atmospheric channel.

Following this, the pressure in the more proximal tubing is increased toallow fluid to escape from the proximal tubing out the atmosphericchannel to clear residual blood from this channel. Next, the cap isreplaced over the atmospheric channel. The stopcock is then closed tothe atmospheric channel and opened to the distal tubing segment toreestablish the original fluid communication between the proximal anddistal tubing. Following this, the pressure is again increased in theproximal tubing so that fluid will enter the distal tubing from theproximal tubing, thereby forcing the fluid within the distal tubing backinto the vascular system through the catheter. As a result, the tubingsystem again becomes entirely filled with electrolyte or dextrosesolution.

Several problems exist in the prior art. First, the procedure oftenrequires the initial sample of blood (which is obtained to clear theresident fluid from the tubing) to be discarded, since it is diluted bythe withdrawal procedure. This results in a loss of blood from thepatient which is cumulative over many sample aspirations. Eventually,this can produce anemia and could necessitate a blood transfusion toreplace such cumulative blood losses. (See "Phlebotomy For DiagnosticLaboratory Tests In Adults, Pattern Of Use and Effect On TransfusionRequirements", New England Journal of Medicine, Vol. 31, p. 1233, 1986;and "Medical Vampires" (Editorial), New England Journal Of Medicine,Vol. 31, p. 1250, 1986).

Patients who require many blood samples to be taken during protractedillnesses or after severe trauma may require transfusions which wouldnot otherwise be necessary, and may therefore be subject to theincreased risk of blood transfusion related infectious diseases such ashepatitis and A.I.D.S., for example.

Moreover, the stopcock in conventional systems must frequently be opento a channel which is intermittently exposed to the atmosphere. Hence,there is a significant risk of microorganisms contaminating the stopcockand thereby entering the vascular system producing infections which maybe extremely serious and even fatal. (See "Stopcock: BacterialContamination and Invasive Monitoring Systems", Heart & Lung, Vol. 8, p.100, 1979; and "Stopcock Contamination In An ICU", American Journal ofNursing, Vol. 75, p. 96, 1975).

An additional problem is the potential for dilutional error introducedinto the blood samples obtained. This results when hospital personnelfail to remove enough blood to adequately clear the resident fluid fromthe indwelling catheter and its connected tubing. This has been reportedin the medical literature to cause error in both measured blood gasvalues and hematocrit concentrations. Such erroneous hematocrit valueshave been noted as a potential source of unnecessary blood transfusionsin surgical patients. It has been noted that the first syringe mustwithdraw a volume of intravenous solution and blood that is six timesthe volume of the tubing distal to the stopcock. (See "Errors InIntraoperative Hematocrit Determination", Anesthesiology, Vol. 45, p.357, 1976; and "Effect of Sample Dilutions on Arterial Blood GasDeterminations", Critical Care Medicine, Vol. 13, p. 1067, 1985).

Furthermore, many present conduit systems provide internal diameterswhich vary abruptly over the length of the conduit. The abrupt change indiameters results in areas where fluid flow is not streamlined, andwhere pockets of fluid can gather while the main fluid flow goes onward.Accordingly, when blood is drawn into the system from the catheter todisplace the resident fluid, pockets of residual resident fluid mayremain within the conduit channel. This can dilute any aspirated bloodsamples later drawn.

Another shortcoming is that the present method of obtaining undilutedblood samples from fluid-filled tubing connected with the vascularsystem is cumbersome and inconvenient.

With regard to the needle apparatus and special aspirator plug aspect ofthe invention, the risk of accidental needle puncture has been wellknown for a long time, and for more than a decade has been known as acommon cause of infection of hospital personnel with hepatitis virus.Such needle punctures now are accompanied by the risk of infection withthe AIDS virus. The risk of needle puncture is especially acute duringthe time when needles are inserted into a fluid-filled tubing that isconnected to an indwelling vascular catheter to obtain a blood sample.Tubing systems heretofore used have often included septums for bloodsampling or medication injection. These septae are designed to bepunctured by sharp needles to allow entry of the needle into the tubingso that the needle tip is in fluid communication with the liquid withinthe tubing.

Such insertion of the needle into the tubing allows a blood sample to beaspirated from the tubing, or allows injection of medication into thetubing. The needles used to penetrate these septae are sharp and caneasily penetrate human skin with even casual inadvertent contact. Inaddition, misdirection of the needle tip against the skin with the thesame force required to penetrate into the septum will invariably causeskin puncture accompanied by the risk of a fatal or extremely hazardousinfection.

Hence, there has long been a need to solve the problem of accidentalneedle sticks associated with penetrating a septae in order to withdrawblood or inject medication.

SUMMARY OF INVENTION

The present invention has features which improve over the art. Thepresent invention allows aspiration of undiluted blood samples fromtubing connected to arterial catheters without opening the tubing systemto the atmosphere. With the present invention, there is no need todiscard an initial blood sample. Hence, this invention eliminates theloss of blood samples through discard and reduces the potential for theintroduction of micrcorganisms into the vasculature.

The features of the invention additionally reduce the exposure ofhospital personnel to blood products, and hence reduces exposure of suchpersonnel to contraction of diseases carried by blood products. With useof the present invention, there will be a reduction in the number oftransfusions, especially in neonates and patients with protractedcritical illnesses.

The invention may significantly reduce the incidence of nosocomialbacteremia and the associated morbidity and mortality caused by theintroduction of microorganisms into tubing through conventionalstop-cocks. Moreover, the present invention simplifies the procedure.The invention reduces the potential for measurement error introduced bythe dilution of the blood samples obtained.

An embodiment of the invention comprises proximal, intermediate anddistal tubing sections. The proximal section can be in fluid flowconnection with a source of higher fluid pressure. Such source can be aliquid-filled container of intravenous fluid such as dextrose orelectrolyte, which is elevated or surrounded by a source of increasedpressure, for example, a pressure bag. The proximal tubing sectionextends to a two-way valve. The two-way valve is further connected tothe intermediate tubing section. The intermediate tubing is connected toan aspirator receiver. The aspirator receiver is in turn connected tothe distal tubing. The distal tube connects to an indwelling catheter.

In one position, the valve connects the intermediate tubing with areservoir. In the other position, the valve connects the intermediatetubing with the proximal tubing and hence with the aspirator receiverand the distal tubing.

A clamp or valve can be placed with the intermediate tubing to eitherblock or permit liquid flow therethrough.

The aspirator receiver can comprise a housing in liquid communicationwith the intermediate and distal tubes. The housing has a portioncomprising a resilient material, such as silicone. In an embodiment,part of the housing can be of rigid material which comprises a casing,and the resilient material can fit within a bore of the casing. Thehousing has a chamber in liquid flow communication with the distal andproximal tubes. The resilient material allows a needle to perforate itso that the needle enters the aspiration chamber. The resilient materialautomatically seals the perforation produced by the needle when theneedle is withdrawn therefrom.

The casing bore can be frustum-shaped. The resilient material can be aplug of conforming shape. In an embodiment, the plug can be of slightlygreater diameter than the diameter of the frustum bore so that the plugmust be slightly compressed to completely fill the bore when insertedtherein. Alternatively, the resilient portion and the casing can bemolded together.

The insertion of a needle into the plug will be accommodated by elasticcompression of the plug material against the needle. The chamberpreferably comprises a cylindrical bore which abuts the plug apex. Theplug apex curves to correspond to the curve of the chamber bore to allowsmooth liquid flow and prevent trapping of blood or dextrose thereabout.

The reservoir has means for changing pressure within the reservoir, suchas a piston which can be locked into both the fully extended intake ordischarge positions. When the two-way valve connects the reservoir tothe intermediate tube, liquid enters the reservoir from the intermediatetube when the reservoir pressure is below the intermediate tubepressure. Liquid is discharged into the intermediate tubing when thereservoir pressure is greater than the intermediate tube pressure. Theintermediate tube can have an enlarged section, or a spiralled section.In either case, the intermediate tube is designed to accommodatesubstantial volume as will be described below with the linear distancefrom end to end of the intermediate tube shortened to facilitatehandling and operation.

The reservoir has an internal liquid volume potential equal to X. Thevolume X is also equal to a volume of blood which, when withdrawn fromthe vasculature through the catheter, through the distal tubing, throughthe aspirator chamber, and a portion of the intermediate tubing, causesdisplacement of substantially all the resident fluid from the catheter,the distal tubing, aspiration chamber, and a portion of the intermediatetubing. When the reservoir is filled with volume X of liquid from theintermediate tube, the blood enters the catheter, and the catheter, thedistal tubing, and the aspiration chamber, and a portion of theintermediate tubing are thus filled with essentially undiluted blood.Closure of the clamp or valve is preferably on the intermediate tubingat a point so that after the reservoir has been filled with volume X ofaspirated liquid from the distal portion of the assembly, the clamp orvalve can be closed to isolate a segment of the apparatus distal theretowhich contains essentially undiluted blood. Alternatively, the reservoirmay be locked in the filled position so that substantial fluid flowcannot occur from the intermediate tubing and the aspiration chamberwhen the above designated clamp is absent. The predesignated volume Xrelationship, therefore, provides for consistent and predictabledilution free blood aspiration from the aspirator receiver chamber aswill be described below.

When the reservoir is filled and a volume X of fluid has entered thereservoir and a volume X of blood has entered the catheter and apparatusthrough the distal tip of the catheter, the column of fluid within theassembly comprises three basic segments which progressively mergetogether: a distal segment composed of substantially undiluted blood, anintermediate segment of blood mixed with resident fluid, and a proximalsegment of resident fluid which contains essentially no blood. The sumof the internal potential fluid volumes of the catheter, the distaltubing segment, the aspirator receiver chamber, and the intermediatetubing is equal to a volume of Y. The volume Y is greater than the sumof the fluid volumes of the distal segment of essentially undilutedblood and the intermediate segment of blood-resident fluid admixtureformed by the above described withdrawal maneuver. Therefore, a proximalportion of the intermediate tubing will contain resident fluid withessentially no blood after the volume X of blood has entered through thecatheter into the assembly in response to the withdrawal of the volume Xof resident fluid into the reservoir. The volume Y can be considerablylarger than the volume X to accommodate variability in the volume ofresident fluid which directly mixes with the blood. Thus, blood does notenter the reservoir during such withdrawal. Therefore, the predesignatedvolume Y relationship provides for prevention of the potential for bloodclot formation within the reservoir by preventing blood from enteringthe reservoir during reservoir filling.

The invention is operated by first opening the two-way valve to connectthe reservoir and the intermediate tube. The intermediate tube clamp orvalve is open. The reservoir pressure is then reduced to besubstantially less than the liquid pressure in the intermediate tube (ifthat pressure is already not substantially less). A volume of fluidequal to X then enters the reservoir from the intermediate tube. Thereservoir then may be locked to maintain the volume X dimensions. Avolume of blood equal to X will enter the catheter, distal tube,aspiration chamber, and part of the intermediate tube, as the residentfluid in those parts is displaced proximally through the apparatus, downthe pressure gradient generated by the lower reservoir pressure. Theintermediate tube clamp or valve is then closed to isolate the blood inthe blood aspiration chamber and the part of the apparatus distalthereto, from the blood and liquid proximal to the clamp.

The blood now in the aspiration chamber, the distal tube, and thecatheter is virtually undiluted blood. This is because the volume X ispredetermined by design to be a volume which virtually completelydisplaces all resident liquid in juxtaposition with and distal to theaspiration point of the chamber (and distal to the clamp in theintermediate tube if provided) when said Volume X is withdrawn into thereservoir as described and replaced by blood entering through anindwelling catheter. A needle connected to a syringe or vacuum-filledcontainer is then inserted through the resilient part of the aspiratorreceiver until the needle tip enters the blood filled chamber.

Blood is then aspirated into the syringe or container from the chamberwith additional blood replacing the aspirated blood through theindwelling catheter. Either the locking of the reservoir fully in thewithdrawn position (when the two-way valve connects the reservoir intothe intermediate tube) or the closing of the intermediate tube clamp canprevent substantial flow of fluid from the intermediate tube into theaspirator receiver chamber. Both may be provided in the preferredembodiment to reduce the chance of procedural error during operation ofthe apparatus.

Once a satisfactory sample has been obtained, the syringe needle iswithdrawn from the resilient section. The resilient sectionautomatically seals the perforation produced by the needle. The clamp isthen opened and the reservoir pressure raised so that the volume X offluid will re-enter the intermediate tube from the reservoir. Thisproduces a pressure gradient which drives much of the blood whichpreviously entered the apparatus back into the vascular system. Thetwo-way valve is then closed to the reservoir and positioned to placethe intermediate and proximal tubes in liquid communication. Thepressure in the proximal tube can then be increased if desired, todisplace any residual blood from the apparatus into the vasculature.

In a modification, the aspiration chamber can have a flow path to moreeasily displace air from the chamber when the aspiration assembly isinitially installed. It can be desirable to decrease the internaldiameter of the tubing extending from the distal side of the aspirationchamber to the patient. However, the aspiration chamber itself must belarge enough to accommodate the blunt needle, to be later discussed.Hence, the central portion of the internal flow path of the chamber maybe enlarged relative to the distal and proximal portions.

Therefore, a reduction in liquid flow velocity within the enlargedcentral portion may occur as liquid flows through the central portion ofthe aspiration chamber. This makes it normally more difficult to removeair bubbles which may collect in the enlarged section within thechamber. In a modified chamber, the flow path through the chamber isdesigned to create more turbulent flow to increase the ability of theliquid, such as saline solution, to shear away air bubbles adhering tothe surface of the chamber walls.

In one specific embodiment, the flow path through the aspiration chamberrises upwardly and thence descends to provide for more flow turbulence.The lower surface of the plug is shaped to accommodate the rise in thechamber flow path.

In a modification, the intermediate tube can comprise a capacitance coilextending in a rectangular rigid casing in a flat plane. The bore can beoblong or elliptical. This design is to achieve maximum volume of thecapacitance chamber with minimum topographical surface area. This makesthe capacitance casing more easily attachable to a patient. The rigidityof the casing prevents dampening of the pressure waveform within theassembly when it is in fluid connection with a patient's artery. Thismakes blood pressure readings more reliable.

It is therefore an object of the present invention to provide a methodand apparatus of blood aspiration through an indwelling catheter whichdoes not require an initial diluted sample of blood to be collected andwasted (or exposed to a high risk of coagulation or contamination)before the undiluted specimen for analysis is collected.

It is further an object of the invention to provide a method andapparatus of blood aspiration through an indwelling catheter which doesnot require any channel in fluid connection with the vascular system tobe exposed to the atmosphere.

Moreover, an object of the invention is to provide a method andapparatus of blood aspiration which reduces the exposure of hospitalpersonnel to blood products and simplifies the blood aspiration process.

It is yet another object of the invention to provide a method andapparatus of blood aspiration which predictably reduces the risk ofmeasurement error which may be introduced by the dilution of bloodsamples by fluid from within indwelling catheters or connected tubing.

An additional object of the invention is to provide a channel throughoutwhich flow is substantially unobstructed and hence efficient indisplacing resident liquid in the distal channel by blood enteringthrough the catheter. This minimizes the potential for dilution of bloodsamples by residual pockets of resident liquid within the channel whenblood is aspirated. This permits smaller blood samples to be taken withthe maintenance of acceptable measurement accuracy.

The invention further solves the problem of accidental needle sticksassociated with insertion of a needle through septae in order towithdraw blood from tubing connected to these septae, or to injectmedication within that tubing. The invention uses a penetratable plug orseptum for use in conjunction with a blood collection or injectiondevice having a blunt needle. The plug is comprised of resilientmaterial having a slit or a perforation extending from its exteriorsurface to its interior surface which is adjacent the liquid within thetube. The plug can be used with the blood aspiration assembly of theinvention.

When a needle is absent from the slit or perforation, the slit orperforation is tightly closed to prevent leakage of fluid from thetubing, such as from the aspiration chamber of the invention, despitehigh pressure within the tubing system.

The contour of the needle tip and the tightness of the seal of the plugslit or perforation are correlated. This correlation assures that theworking force to pass the blunt needle tip into the plug's slit orperforation, is considerably less than the force required to cause thetip of the blunt needle to cause the tip of the blunt needle topenetrate normal intact human skin of the hands or arms.

The presence of the perforation or slit in the plug allows the bluntneedle to obtain initial penetration into the plug with a small amountof force. The initial insertion of the blunt needle acts to hold theblunt needle in alignment for further application of force to move theneedle tip into the aspiration chamber.

Since the force required to pass the tip of the blunt needle into theseptum is considerably less than the force required to penetrate thesurface of normal intact human skin of the hand, accidental misdirectionof such forces through the needle tip against the skin will not resultin penetration. Therefore, the risk of needlestick while obtaining ablood sample through the septum should be virtually eliminated.

The blunt needle has a tip with an enlarged surface area that does noteasily pierce the human skin, but which will penetrate the perforated orslitted plug without difficulty. The blunt needle tip can be rounded orflat, with a side opening for the needle bore. The side opening providesa broader distribution of force over the surface area against whichapplication will be made, as opposed to a tip having an orificeextending through its axis against the surface of application.

The roundness of the tip, and the angle of the tip from the roundedportion toward the proximal end of the needle is such to effectpenetration of the perforated or slitted plug but reduce the chance ofaccidental skin puncture. The shape of the needle leading to the tip canbe of a generally conical shape to thus provide greater rigidity of theneedle, since the initial penetration of the perforated or slitted plugcan be achieved by the smaller rounded or flattened tip.

The force required for the blunt needle to penetrate the skin is muchgreater than that needed for a conventional steel needle to penetratethe skin. As a result, the risk of skin puncture by casual contact withthe blunt needle is much less than the risk with the conventional steelneedle.

The blunt needle apparatus has a stop, which can be of annular shape,which contacts the aspirator assembly to prevent the tip of the needlefrom contacting the interior wall of the aspiration chamber. A means forgripping and turning the blunt needle apparatus so that it can beaffixed to a syringe, such as projecting flanges, is provided.

In a modification, the plug or septum has an upper part combined with alower part. The upper part is resilient but is more compliant than thelower part. Both the upper and lower part have either a slit orperforation extending in alignment. This alignment guides the bluntneedle inserted through the slit or perforation in the top part into theopening of the slit or perforation in the bottom part. When the bluntneedle is inserted through the more pliable first part, the slit or theperforation splints the needle in position to be more stable when thegreater force is needed to penetrate the less pliable second part.

The first and second parts of the plug both grip against the needle whenthe needle tip is inserted to within the aspiration chamber of thetubing. The grip is stronger for the bottom part than for the top part.A tight seal is provided by such gripping to prevent the pressurizedliquid within the aspiration chamber or within the tubing, from leakingthrough the perforation or slit in the plug to pass outside of the upperplug.

The penetratable plug or septum used with a blunt needle greatlyimproves the elimination of infection and injury caused by accidentalneedlestick.

DESCRIPTION OF THE DRAWINGS

FIG. 1A shows the proximal part of the assembly, with some parts shownin section, and some parts broken, with a schematic for the high fluidpressure source;

FIG. 1B shows the distal part of the assembly, with some parts shown insection and some parts broken;

FIG. 2 is a section taken on the line 2--2 of FIG. 1A;

FIG. 3 is a section of the reservoir, taken on the line 3--3 of FIG. 1A;

FIG. 4 is a section of the reservoir showing the piston rod turned tolock the rod and piston in the fully discharged-position;

FIG. 5 is a section of the assembly taken on the line 5--5 of FIG. 1B;

FIG. 6 is a section through the aspiration chamber taken on the line6--6 of FIG. 1B;

FIG. 7 is a bottom plan view of the resilient portion of the aspirationchamber housing;

FIG. 8 is a side view of the resilient portion of the aspiration chamberhousing;

FIG. 9 shows a modification wherein the intermediate tubing has aspiraled section; and

FIG. 10 is a modification wherein the intermediate tubing is of the samediameter throughout and straight.

FIG. 11 shows a top plan view of a modification utilizing a modifiedreceiver arrangement;

FIG. 12 is a section view taken on the line 12--12 of FIG. 11;

FIG. 13 is a section view taken on the line 13--13 of FIG. 12, alsoshowing a blunt needle above the modified aspiration assembly;

FIG. 14 is a side elevation of the two-part resilient plug of themodified aspiration assembly;

FIG. 15 is a bottom plan view of the plug as shown in FIG. 14;

FIG. 16 is an exploded section view of the two-part resilient plug;

FIG. 17 is a top plan view of a modification of an aspiration assemblyand a modification of a resilient plug, showing a cylindricalperforation or orifice extending through the plug, rather than a slit;

FIG. 18 is a section on the aspiration assembly and plug taken on theline 18--18 of FIG. 17;

FIG. 19 is a section taken on the line 19--19 of FIG. 18;

FIG. 20 is an exploded sectional view of the aspiration assembly, plugand retention ring;

FIG. 21 is a section taken on the line 21--21 of FIG. 20;

FIG. 22 is a top plan view of the aspiration assembly with the resilientplug and retainer ring removed;

FIG. 23 is a side view of the blunt needle apparatus shown attached to asyringe depicted in dashed lines;

FIG. 24 is a section of the blunt needle apparatus taken on the line24--24 of FIG. 23;

FIG. 25 is an isometric view of the blunt needle apparatus;

FIG. 26 is a view of the distal end of the blunt needle apparatusshowing more clearly the curvature at the needle tip;

FIG. 27 is a section of the needle tip taken on the line 27--27 of FIG.26.

FIG. 28 is an elevation of a modification of the blunt needle, having aflat ended tip; and

FIG. 29 is a section taken on the line 29--29 of FIG. 31.

FIG. 30 is an elevation showing a modified capacitance chamber;

FIG. 31 is a longitudinal section of the capacitance chamber shown inFIG. 30; and

FIG. 32 is a section of the capacitance chamber taken on the line 32--32of FIG. 30.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENT

The blood aspiration assembly 20 has generally a proximal end 22 shownin FIG. 1A and a distal end shown generally as 24 in FIG. 1B. Thisdescription will work from the proximal end 22 toward the distal end 24.A high fluid pressure source shown schematically as 26 can comprise afluid-filled container which is elevated, or which is surrounded by asource of increased pressure, for example, a pressure bag. Source 26 canhave intravenous fluid therein. The pressure source 26 is in liquid flowconnection with proximal flexible tubing section 28. Tubing 28 has itsdistal end connected by means known in the art to a coupling 30 for atrigger squeeze valve mechanism 32. The proximal tubing has anothersection 36 with its proximal end in liquid flow connection by knownmeans to the distal end of trigger valve mechanism 32.

The distal end 38 of proximal tube section 36 is telescopically receivedwithin the port sleeve 40 of a housing 42 for a two-way valve 44. Valvehousing 42 has a port sleeve 46 which telescopically receives thecylindrical end 48 of a flexible intermediate tube 50. Valve housing 42further has a port sleeve 52 which is connected to a reservoir to bedescribed.

The valve 44 has an interior body 54 having T-shaped flow channels 56,as known in the art, extending therethrough. Body 54 is rotatable by ahandle 57. FIG. 1A shows valve body 54 positioned for liquid flowbetween ports 46 and 52, with flow from those ports to proximal port 40being blocked. Handle 57 can rotate body 54 to connect ports 40 and 46for liquid flow therebetween, and block flow from those ports to port52. In the preferred embodiment, rotation of handle 57 is limited toninety degrees so that port 40 cannot be connected to port 52. Rotationof handle 57 only 45° will block liquid flow between all three ports.

Port sleeve 52 telescopically receives and holds as by adhesive thecylindrical distal end 58 of a housing 60 of a reservoir 61. The housing60 further comprises a frusto conical section 62 connected to distal end58 and to a larger cylindrical section 64. The proximal end of section64 has an outwardly extending annular flange 66. Distal thereto is anannular rib 68 with an annular slot (unnumbered) formed therebetweenwhich receives the annular distal end 70 of an accordion pleated boot72. Boot 72 can be of a flexible plastic with a plurality of pleatedsections, as shown. At the proximal end of cylindrical section 64, aplastic disc 74 is mounted to telescopically fit within the slot formedinterior of annular flange 66 and held as by adhesive. Disc 74 has acentral cylindrical bore 76 having a pair of oppositely extending slots78. Housing 60, disc 74 and valve housing 42 can be transparent plastic.

A plunger assembly 82 comprises a frustum-shaped piston 84 of plasticwith slanted wall 85. Piston 84 is connected to a rod 86 which extendsproximally into a ring handle 88. Part of rod 86 has a pair ofoppositely extending linear lock flanges 90. Rod 86 and flanges 90 aresized to be snugly telescopically received through the conforming bore76 and slots 78 in disc 74. Between ring 88 and flanges 90, rod 86 hasan annular groove (unnumbered) that receives and holds as by adhesivethe annular proximal boot end 94.

The piston 84 is sized so that its outer extremeties are snugly andtelescopically fitted against the interior of housing section 64. Piston84 maintains a tight seal against section 64 to thus prevent liquid frompassing from the distal to the proximal side of piston 84 during piston84 compression.

Piston wall 85 conforms with the shape of reservoir housing wall 62 tobe pressed snugly there-against when rod 86 is in the full dischargeposition. When piston 84 reaches this position, the proximal ends oflock flanges 90 extend just beyond the distal side of disc 74. To lockin this position handle 88 can then rotate rod 86 ninety degrees. Next,handle 88 is released. The proximal ends of flanges 90, having beenrotated ninety degrees, press against the distal side of stop disc 74 tohold piston 84 locked in a discharge position (FIG. 4).

To move the piston 84 from this position to lock in the fully withdrawnposition, the handle 88 can be rotated to align flanges 90 with slots78. The handle 88 can be pulled proximally to move the distal ends offlanges 90 just beyond the proximal side of stop disc 74. Handle 88 isthen rotated ninety degrees and released so that flanges 90 both extendperpendicular to the slots 78. The distal ends of flanges 90 abut theproximal side of stop disc 74 to lock rod 86 and piston 84 againstdistal movement.

Returning to intermediate tube 50, from its proximal end 48, tube 50tapers at 96 into an enlarged section 98 which thence tapers at 100(FIG. 1B) toward a smaller part 102. Part 102 extends into a distal tubeend 104.

A blood aspirator receiver means 106 comprises a housing 108. Housing108 includes a main liquid flow path or chamber 110. Housing 108 has acasing 111 which comprises a cylindrical sleeve 112 having an internalcylindrical bore 114. Bore 114 telescopically and snugly receives andholds tube end 104 as by adhesive. Bore 114 extends into and intersectsa smaller central bore 116 which is part of chamber 110. Bore 116extends distally to intersect with a larger bore 118 located within adistal sleeve 120 that is part of casing 111. Bore 118 telescopicallyreceives and snugly holds as by adhesive the proximal end 122 of aflexible distal tube 125. As seen in FIGS. 5 and 6, the bottom of casing111 located between sleeves 112 and 120 is rounded at 126 to provideadditional strength.

Casing 111 has an externally threaded cylindrical extension 128 which isintegral with sleeves 112 and 120. Extension 128 has an ellipticalfrustum-shaped bore 134. Bore 134 can be filled with a resilientmaterial such as silicone rubber or the like to form a plug 136. Plug136 is shown isolated in FIGS. 7 and 8. Plug 136 has a cylindricalarcuate bottom 138 of the same curvature as housing bore 116, as seenspecifically in FIG. 6. As a result, liquid such as blood or dextrosesolution, will flow smoothly through the portion of flow path or chamber110 which is adjacent the juncture of plug bottom 138 with bore 116.This prevents any liquid such as dextrose solution or other initialresident fluid within housing 108 from accumulating within the flow pathor chamber 110 when resident fluid is being withdrawn from aspiratorreceiver means 106.

The resilient plug 136 can be molded with the more rigid plastic casing111 so that the plug 136 securely bonds to the bore 134. Alternatively,the plug 136 can be molded separately and installed in bore 134. In thiscase the truncated plug bottom 138 is of slightly greater diameter thanthe diameter of the apex of bore 134. The plug 136 must hence beslightly compressed to fill bore 134 when it is inserted therein.

The lateral expansion forces induced by accommodation of the additionalvolume of any needle inserted into plug 136 will be met by additionalelastic compression of the resilient material, since the diameter ofplug 136 cannot be increased due to the limitations of the surroundingbore 134. The resilient plug 136 can tightly seal the perforationproduced by a needle through elastic reexpansion of the plug materialafter needle withdrawal.

The aspirator receiver means 106 further has a cap 142. Cap 142 has(FIG. 6) a depending internally threaded sleeve 144 to screw aboutextension 128. The inside surface 146 of cap top wall 148 screws flushagainst the flat top of extension 128 and the flat top 150 of plug 136.Cap wall 148 has a central funnel-shaped bore 151.

As seen in FIG. 5, the internal diameter of both tube ends 104 and 122(not shown) is of the same internal diameter as housing bore 116 tolikewise provide streamlined flow between tube ends 104 and 122 and bore116. This prevents any buildup of dextrose solution or other residentfluid to avoid such buildup diluting any blood sample withdrawn fromchamber 110, and also prevents buildup of blood when resident liquidreenters the housing 108 as will be described.

As seen in FIG. 1B, a plastic clamp 154 of the type commonly known inthe art has openings at its proximal and distal ends to receive tubesection 102. A lever arm 156 can be moved to have its end locked bycatch 158 so that the tube 102 is clamped closed by the pincher pointsat 160 and 162.

Distal tube 125 extends distally to a female catheter connector fitting170, as known in the art. The fitting 170 receives a catheter connectorsleeve 172 which is connected to a catheter 174 as known in the art.

FIG. 9 shows a modification of the intermediate tube. The modified tube50' has a spiralled or coiled tubing section 180 as contrasted to theenlarged section 98 shown in FIGS. 1A and 1B. With either the FIG. 9 orFIGS. 1A and 1B version, the overall length of the intermediate tube isshorter than it would be if the intermediate tube had a uniform diametersuch as that of the distal tube end 104, as pictured as 50" in FIG. 10.

In operation, catheter 174 is indwelling and clamp 154 is open as shownin FIG. 1B. Piston 84 of reservoir 61 is in the maximum dischargeposition with its wall 85 abutting the interior of housing wall 62. Theplunger rod 86 has its lock flanges 90 at a ninety degree angle with theslot 78 in stop disc 74, as shown in FIG. 4.

Valve 44 is positioned to connect port 40 to port 46. From thispositioning, the intravenous fluid from the high fluid pressure source26 has filled the tubing 28, the conduit in trigger 32, the tubing 36,the port sleeves 40 and 46, intermediate tubing 50, chamber 110, distaltubing 125, fitting 170, connector 172 and catheter 174.

With the valve 44 so positioned, the pressure within the blood vesselcan be monitored, or fluid administered, depending on the function ofthe device, or devices, connected proximally to the tubing 28.

Valve 44 is then positioned to connect reservoir port 52 to distal port46. In so doing, port 40 and hence source 26 are blocked from connectionwith ports 46 and 52.

Now the assembly 20 can be operated to withdraw blood from the patientfor sampling. Plunger handle 88 rotates ninety degrees to align lockflanges 90 with disc slots 78. The handle is moved proximally until thedistal ends of flanges 90 pass beyond disc 74. Handle 88 and rod 86 arerotated ninety degrees to lock rod 86 in this fully withdrawn positionas aforesaid. In this position, the proximal flat end of piston 84 isadjacent the distal side of disc 74.

With the piston 84 so withdrawn, a volume X of resident intravenousfluid is drawn within the reservoir housing 60 from the port sleeves 52and 46, and intermediate tube 50. As such withdrawal occurs, theresident fluid within catheter 174, connector 172 and fitting 170,distal tube 125 and chamber 110 moves into the intermediate tube 50.

Further as such withdrawal occurs, blood flows through catheter 174 intointermediate tube 50. The sum of the internal potential liquid volumesof catheter 174, connector 172 and fitting 170, distal tube 125, chamber110, and intermediate tube 50, is equal to a volume of Y. The volume Yis greater than the sum of the liquid volumes of the distal segment ofundiluted blood and the intermediate segment of blood-resident fluidadmixture which are formed within assembly 20 by the flow of the volumeX of blood into assembly 20 through catheter 174 as a result ofwithdrawing volume X of resident fluid into reservoir housing 60. Thispredesignated volume relationship allows for proximal end 48 ofintermediate tube 50 to contain essentially only resident fluid afterthe volume X of resident fluid has been withdrawn into the reservoirhousing 60 from the intermediate tube 50, so that blood does not enterthe reservoir housing 60 during such withdrawal.

For purposes of illustration, the volume X which can be withdrawn intoreservoir housing 60 is equal to the internal liquid volume of the flowchannels distal to a point shown as X in FIGS. 1A, 9 and 10. After suchwithdrawal is complete, the flow channel within intermediate tube 50contains a mixture of blood and resident fluid at the point shown as X.Distal to this point the blood-resident fluid mixture progressivelymerges with essentially undiluted blood such that only substantiallyundiluted blood is contained within the flow channels distal to theclamp pinch points 160 and 162. Proximal to the point marked X, theblood-resident fluid mixture progressively merges with resident fluidwhich contains substantially no blood such that only resident fluid iscontained within the flow channel at proximal end 48 of intermediatetube 50. Therefore, with such withdrawal, blood replaces substantiallyall resident fluid within chamber 110 but does not enter reservoirhousing 60.

Hence, after reservoir housing 60 is filled with fluid and clamp 154closed, the blood aspiration chamber 110 and all tubing distal to theclamp pinch points 160 and 162 are filled with essentially undilutedblood which is virtually free of resident fluid and isolated from theproximal tubing system. The volume X is predetermined by design to allowadequate clearing of substantially all of the resident fluid from theblood aspiration chamber 110 and all tubing distal to the clamp pinchpoints 160 and 162 and volume Y is predetermined by design to preventblood from entering the reservoir 61.

With the blood now in the aspiration chamber 110, aspiration of theblood for sampling can be conducted. Clamp 154 is moved to the closedposition with lever 156 held by catch 158 so that pinch points 160 and162 press firmly against intermediate tube section 100 to block flowtherein from one side of the points 160 and 162 to the other.

A needle 185 (FIG. 1B) of a typical needle syringe (not shown) or vacuumfilled container (not shown) is moved through the funnel cap bore 151 topass through plug 136 so that the needle point is inserted within thechamber 110. The syringe or vacuum filled container (not shown)aspirates as known in the art so that blood is aspirated from chamber110 through needle 185 into the syringe or container (not shown). Withthis sample being taken, needle 185 is withdrawn from plug 136 and thesample of blood taken for proper analysis. Upon withdrawal of needle185, the elastic material of plug 136 seals the needle perforation.

The withdrawn blood is replaced by additional blood from the patientflowing into catheter 174 toward chamber 110, since the clamp 154 hasblocked off any liquid flow proximal of pinch points 160 and 162.

Following the taking of the blood sample and removal of needle 185, theclamp 154 can then be moved to the open position of FIG. 1B. Plungerhandle 88 is rotated, moved to and locked in the fully dischargedposition with wall 85 abutting housing wall 62. This displaces theintravenous fluid from housing 60 back into the intermediate tube 50,chamber 110 and all tubing and connections distal thereto, therebyeffectively clearing much of the residual blood from those flow paths.The two-way valve 44 is then rotated to connect ports 46 and 40 andblock flow to and from reservoir port 52.

Any additional residual blood in the tubing and chamber 110 can becleared by additional irrigation from the high fluid pressure source 26.

Cap 142 helps maintain plug 136 in the position shown, by counteractingany internal pressure in chamber 110 greater than atmospheric pressure,and resisting any tendency of the plug 136 to move with withdrawal ofneedle 185. The sloping surface of cap funnel bore 148 helps direct theneedle 185 into the plug 136.

When the piston 84 is locked in the fully withdrawn position asaforesaid, such locking and holding of the reservoir 61 volume fixedwill prevent flow of liquid from the second conduit toward the aspiratorchamber 110 even when the clamp 154 is not employed. Hence, the lockingof the piston 84 in such position is a means to inhibit flow of liquidin the second conduit toward the chamber 110 during aspiration throughneedle 185.

FIGS. 11-16 show a modified aspiration assembly 202 for use with a bluntneedle apparatus to be described. Assembly 202 shows a modified housing108' with a modified casing 111'. Casing 111' has cylindrical sleeves112' and 120' which receives tube ends 104 and 122, respectively, in themanner heretofore described.

Casing 111' likewise has an upright externally threaded extension 128',with an elliptical frustum-shaped bore, like bore 134 heretoforedescribed, which is filled with a plug 136'. Plug 136' is comprised ofan upper part 208 and a lower part 210. As seen in FIG. 16, the top ofupper part 208 has an arcuate recess 212, while the bottom has aprojecting ridge 214.

Bottom plug part 210 has an upper recess 216 shaped to snugly receivethe ridge 214. The bottom surface of plug part 208 is held to the top ofplug part 210, so that the two fit together, as seen in FIGS. 12 and 13,when they are within the extension 128'. A slit 218a extends throughplug part 208 from the top recess 212 through the bottom ridge 214. Theslit 218a is in longitudinal alignment with the sleeve 112' of casing111'. Lower plug part 210 likewise has a slit 218b aligned with slit218a, to form a continuous slit through the plug 136'.

Upper plug part 208 is comprised of a more compliant material than lowerpart 210, although both materials can be of silicone rubber, forexample. Cap 142 fits on extension 128' as heretofore described. The capbore 151 has its bottom opening aligned with slit 218a.

FIGS. 17-22 show another modification of the aspiration assembly 220,with a resilient plug having an orifice or perforation extendingtherethrough, and having a different flow path. Assembly 220 has amodified housing 108" with a modified casing 111". Casing 111" hascylindrical sleeves 112" and 120" which receive tube ends 104 and 122,respectively, as by adhesive. It is noted that the views of theaspiration assembly of FIGS. 17-21 are reversed from that in FIGS. 1Band 11 & 12. The casing 111" has a modified chamber 110". The lower partof casing 111" has a raised hump 221 having a raised floor 222 withslanted sides 223. A hollow 233 extends longitudinally through hump 221,as shown in FIG. 19, to divide the hump into two opposing ridges 234.

As seen in FIGS. 18 and 22, the upper side edges 235 of the ridges 234are curved upwardly and outwardly. The plug or septum 136" has a lowerconical recess 237. Recess 237 is shaped to conform to the shape ofridges 234, so that a conduit is provided by the hollow 233 and the partof plug recess 237 extending about hollow 233. Because of theaforementioned curvature of the ridges 234, the said conduit has anenlarged central portion 238 and two smaller portions 239 in flowconnection therewith.

The upper surface of plug 136" has a small central target recess 244 ofa generally conical or arcuate shape. An orifice or perforation 246extends through the axis of plug 136" to connect the center of the upperrecess 244 to the center of lower plug recess 237. This perforation in apreferred embodiment is made by penetrating the plug 136" with a steelneedle having an outside diameter of 1.5 mm.

The annular upper perimeter of plug 136" is recessed to receive anannular plastic retainer ring 250. Ring 250 can be held against theinner wall of extension 128" as by adhesive, to thus retain plug 136"therein.

This design is advantageous in completely displacing air from theassembly 108" when it is installed. When the saline solution isinitially placed in the high fluid pressure source 26, the system isirrigated from the proximal side to the distal side of the assembly108°. This is generally done by squeezing a high pressure valve so thatfluid comes from the source 26 under high pressure through tubing 28 andthence to the aspiration assembly 108". It is important to remove allthe air bubbles as easily as possible.

The chamber 110" is enlarged to accommodate the blunt needle to bedescribed. As a result, flow velocity from either of the more narrowconduit flow paths 239 into the larger central conduit portion 238 isreduced. The raised floor 222 and its slanted sides 223 create aturbulent flow path for liquid passing therethrough. This turbulenceincreases the probability of the flowing liquid catching air bubbleswhich adhere to the walls of chamber 110" and shearing the bubbles awayfrom the walls during initial preparation of the assembly beforeattachment to the patient. Thus, the air bubbles are removed to avoid apossible embolism or other injury caused by injection of an air bubbleinto the vasculature of the patient during subsequent use of theassembly.

The needle apparatus 270 (FIG. 25) comprises a cylindrical base section272. The proximal end of section 272 has integral exterior threads 274.Projecting laterally from opposite sides of base 272 are a pair oflongitudinal gripping flanges 276. Distal to the flanges 276 is anannular stop 278. Stop 278 and flanges 276 are integral with one anotherand with base 272.

A blunt needle 280 has its proximal end integral with stop 278. Needleassembly 270 is thus one unitary integral and composite piece which canbe molded as of plastic, such as polycarbonate, orpolytetrafluorethylene resin such as that sold under the trademarkTeflon.

Referring to FIGS. 26 and 27, needle 280 has a rounded tip 284. Theradius of curvature of tip 284 is about 0.25 mm, for use with theperforated plug design shown in FIGS. 18-21. With particular referenceto FIG. 27, one side 288 of the needle 280 near tip 284 is recessed at288.

Needle apparatus base 272 has a slightly tapered longitudinal bore 290which extends distally into a conical tapered section 292. In opencommunication with bore section 290 is the bore 294 of needle 280. Bore294 tapers from a larger diameter to a smaller diameter as it extendsdistally. Near the distal end of needle 280, bore 294 angles atapproximately 20° toward the needle side 288 and has an opening 296through side 288. To the proximal side of opening 296, the needle 280has a smooth slanted edge 298.

Beyond the rounded tip 284, as the needle 280 extends proximally, it canflare out into a conical section 300 having an angle of about 30°, asshown on the right side of FIG. 27. Thence the needle extends into aconical section 301 having a smaller angle than 30°, such as an angle ofabout 20°, also as shown on the right of FIG. 27.

As seen in viewing FIG. 23, the apparatus 270 can be attached to asyringe 325 having a neck 327 and an internally threaded annularmounting fixture 329. The exterior threads 274 of base 272 arethreadingly received within connecting mount 329. This permits liquid toflow through base bore 290 into neck 329 and syringe 325.

The modified aspiration assemblies 202 and 220 are of particular usewhen the aspirating means is the blunt needle apparatus 270, shown inFIGS. 23-27. With respect to assembly 202 of FIGS. 11-16, the bluntplastic needle 280 can be targeted through the cap bore 151 into therecess 212 of upper plug part 208. The arcuate shape of the recess 212helps to guide the needle 280 toward the slit 218a. Further downwardpressure on needle 280 moves it easily through slit 218a, through lowerridge 214. As the needle enters the top of lower plug part 210, theangled recess 216 helps to guide needle 280 through the lower slit 218b.The needle 280 can then pass completely through lower plug slit 218binto the bore 116' of chamber 110', as shown in FIG. 24. In this FIG. 24position, it can be seen that the distance from the needle tip 284 tothe distal side of stop 278 is less than the distance from the pointwhere the distal side of stop 278 abuts the top of cap 142. Thisprevents tip 284 from striking the opposing wall of chamber bore 116'.Blood is then aspirated through opening 296 and bores 294 and 292 ofneedle 280 in the same fashion as previously described. Next, the needle280 is withdrawn from slits 218b and 218a, and the blood can be takenelsewhere.

The embodiment of the plug 136" of FIGS. 18-20 can have dimensions ofheight of 0.5 inches (12.7 mm) from the upper surface of the plug 136"extending about recess 244, to the lower surface extending about lowerplug recess 240. The diameter of the plug 136" through its largestdimension can be 0.545 inches (13.84 mm). The angle of the recess 237can be 45°, and the diameter of the recess at its bottom can be 0.40inches (10.16 mm) and the depth of the recess can be 0.175 inches (4.44mm).

The recess of the plug 136" to receive the retainer ring 250 can be 0.10inches (04.54 mm) deep and 0.075 inches (1.9 mm) wide. The upperdiameter of the recess 244 can have a depth of 0.025 inches (0.63 mm)and a width of 0.125 inches (3.18 mm).

The silicone rubber for the plugs 136", can be 50 to 60 Durometer-Amedical grade.

With the described plug 136" design of FIGS. 18-20, with a siliconehaving a hardness of about 50 to 55 Durometer-A medical grade, the depthof penetration into the plug with the polycarbonate needle 280 design asdescribed with the force of one pound applied perpendicular to the plug136" surface is 0.2 inches (5 mm). With a force of 2 pounds (889,600dynes), the said needle 280 design will penetrate the said plug 0.25inches (6.35 mm).

In contrast, using the same blunt needle, penetration of intact normalhuman skin of the dorsum of the hand does not occur at a force of 2pounds (889,600 dynes). In further contrast, a sharp 20-gauge steelneedle of the type conventionally used with the prior art results in thepenetration of the skin of the dorsum of the hand with a force of about0.12 pounds (53,376 dynes).

Since the force required to pass the tip of the blunt needle into theplug or septum is considerably less than the force required to penetratethe surface of normal intact human skin of the hand, accidentalmisdirection of such forces through the blunt needle tip against theskin will not result in penetration. Therefore, the risk of needlestickwhile obtaining a blood sample through the septum with the blunt needleshould be virtually eliminated.

The channelling of the movement of the needle 280 through the remainderof plug 136" is effected by the perforation 246 (FIG. 17) guiding theneedle 280 in the proper direction. Once the initial penetration ofneedle 280 occurs, there is little likelihood of misdirection of theblunt needle 280.

Further, the force to achieve penetration of the skin with the bluntneedle 280 is much greater than that required to achieve skinpenetration with the said sharp steel needle. Hence the chance ofaccidental puncture of the skin by casual inadvertent contact is muchless likely to occur with the blunt needle design 280 than with theconventional sharp steel needle.

With the plug 136" of the described design for FIGS. 18-20, totalpenetration of the plug 136" by the polycarbonate needle 280 havingdimensions heretofore described to position the tip 284 withinaspiration chamber 110", as illustrated in FIG. 24 for aspirationchamber 110', can be performed by a force of 4.2 pounds (18,681,600dynes) applied perpendicular to the plug surface.

Needles 280 having tips with a radius of curvature of 0.20 mm. to about1 mm can also be used with the plug 136" with dimensions previouslydescribed. With larger plugs 136", blunt needle tips having largerradius of curvature than 1 mm, can be used, such as a radius of 2.5 mm.

FIGS. 31 and 32 show a modification of the needle 280 having a modifiedtip 310. The end 314 of tip 310 is flat, and in an embodiment, can havea diameter of 1.0 mm. The tip angle at 312 can be about 15° and canextend proximally into a section 313 having a smaller angle of about10°, as seen viewing FIG. 32 toward the right side. The flat end surface314 can have an area of 0.78 square mm. which can be of circular shape.One side of the distal end of needle 310 is recessed at 318 and has anopening 320 extending therethrough in liquid flow communication withneedle bore 294'.

In contrast with the aforementioned easy penetration of the skinachieved by the typical steel needle, the needle 280 with tip 310 ofFIGS. 31 & 32 fails to penetrate the skin of the dorsum of the hand whendirected against it at a force of 2.3 pounds (1,023,040 dynes). Hence,it too is much less likely than the conventional steel needle topenetrate the human skin accidentally when the aspiration needlecontacts the skin through casual contact.

The force required to achieve depths of penetration of 0.2 inches (5.08mm) and 0.25 inches (6.35 mm) into the plug 136" of dimensionspreviously described, with the flat end needle 310 as described forFIGS. 31 & 32, is substantially the same as the forces given for therounded end needle 280 of dimensions previously described.

Blunt needle 310 having a flat end 314 with diameters of from 0.2 mm. toabout 2 mm. can also be used with the plug 136" described previously.With plugs of larger size, needles 310 with flat end 314 of up to about5 mm. diameter can be used.

Hence, with the blunt needle of FIGS. 31 & 32, and the plug designdescribed, the penetration force needed to obtain initial penetration ofthe plug is less than that required to pierce the human skin. The chanceof piercing the skin by a misdirected needle is thus much less whenusing the blunt needle described for FIGS. 31 and 32, than when using aconventional steel needle.

This needle design of FIGS. 31 & 32 can completely penetrate thepreviously described plug 136" into the aspiration chamber 110" at aperpendicular application force of 5 pounds (2,224,000 dynes).

The needle designs of FIGS. 25-27, and of FIGS. 31 & 32 having solidtips are more preferable than a tip with a longitudinal bore extendingdirectly through it. The FIG. 25-27, 31 and 32 designs provide greaterrigidity and strength, and provide surface area at the tip which betterdistributes force against the skin than with a needle having alongitudinal bore extending through the axis of the tip.

For both the round end and flat end blunt needle, the effective radiusof curvature of the round end, and the diameter or surface area of theflat end, can vary as the angle of the adjacent needle section variesfrom 30 degrees, and can also vary with plugs with silicone of differentranges of hardness to the extent that such designs allow the bluntneedle tip to penetrate into the perforation at forces less than theforces required to cause the needle tip to penetrate into human skin.

FIGS. 30-32 show a modified intermediate tube section 50'". It comprisesa rectangular casing 340 having upper and lower longitudinal sections342 and 344 of strong rigid plastic held together as by adhesive (FIG.31). At the longitudinal ends of casing 340 are a pair of bores 348 and349 which receive cylindrical plastic insert tubes 350 and 352,respectively. Tubes 350 and 352 have raised rounded edges 355 and 357 attheir outer ends.

The ends of the tubes 355 and 357 are in liquid flow communication witha serpentine coil 359 which extends through casing 340. The crosssection of coil 359 is of oblong or elliptical shape as seen in FIG. 31.The oblong or elliptical shaped bore of the serpentine coil minimizesthe top surface area needed to achieve an adequate capacitance volume.This provides for adequate volume in a compact, strong, and noncompliantstructure. The noncompliance is important in order for blood pressurereadings to be made or monitored with a transducer in fluid connectionwith the invention.

As known in the art, the trigger squeeze 32 can be operated to causefluid flow from fluid source 26 into the assembly flow paths distal oftrigger squeeze 32.

There are various changes and modifications which may be made to theinvention as would be apparent to those skilled in the art. However,these changes or modifications are included in the teaching of thedisclosure, and it is intended that the invention be limited only by thescope of the claims appended hereto.

What is claimed is:
 1. In a fluid-filled extra-corporeal bloodaspiration system for sampling pressurized blood from the human body,the system being for connection to a catheter having a bore in fluidcommunication with a pressurized blood vessel, the system having meansfor elevating the fluid pressure above the pressure within said bloodvessel so that fluid flows from the system into the blood vessel and thesystem having means for reducing said fluid pressure below the pressurewithin said blood vessel so that blood flows from said blood vessel intosaid system, the improvement comprising:an aspirator receiver formingpart of the blood aspiration system and including a housing having aflow channel for communication with the human vasculature for flowingblood therethrough, said housing carrying a receiver portion penetrableby a cannula to place a bore of the cannula in communication with saidflow channel and to allow sampling of blood; said receiver portionhaving an open receiver channel formed therein upon penetration thereofby the cannula, said receiver portion being formed of a resilientmaterial whereby said open receiver channel will be normally closedfollowing removal of the cannula; said receiver portion having an upperportion and a lower portion, said upper portion being more compliantthan said lower portion whereby said upper portion is penetrated by thecannula with the application of a lesser force thereto than thatrequired to penetrate the lower portion.
 2. A system as in claim 1,wherein said upper and lower portions of said receiver portion aredefined by separately formed upper and lower receiver elements.
 3. Asystem as in claim 1, wherein said upper receiver portion is formed froma material which is more compliant than a material from which said lowerreceiver portion is formed.
 4. A system as in claim 1, wherein saidupper receiver portion is thicker than said lower receiver portion.
 5. Asystem as in claim 1, in combination with an aspirator including anaxially extending cannula having a blunt distal tip, said cannula havinga bore with first and second openings adjacent opposite ends thereof,said aspirator further including a receptacle in communication with saidbore through said second opening thereof, said cannula being adapted tobe inserted into and through said receiver portion.
 6. Apparatusaccording to claim 1 wherein said receiver portion has inner and outersurfaces, interfacing with the flow channel and ambient atmosphere,respectively, said receiver channel extending between said inner andouter surfaces and normally sealing said housing receiver portionbetween said flow channel and ambient atmosphere so that blood flowingthrough said flow channel is in direct contact with said receiverchannel.
 7. In a fluid-filled extra-corporeal blood aspiration systemfor sampling pressurized blood from the human body, the system being forconnection to a catheter having a bore in fluid communication with apressurized blood vessel, the system having means for elevating thefluid pressure above the pressure within said blood vessel so that fluidflows from the system into the blood vessel and the system having meansfor reducing said fluid pressure below the pressure within said bloodvessel so that blood flows from said blood vessel into said system, theimprovement comprising:an aspirator receiver forming part of the bloodaspiration system and including a housing having an outer surface and aninner surface and having a flow channel for communication with the humanvasculature for flowing blood therethrough, said housing carrying areceiver portion penetrable by a cannula to place a bore of the cannulain communication with said flow channel and to allow sampling of blood;said receiver portion being preperforated to form a receiver channel forreceiving the cannula upon penetration thereof by the cannula, saidreceiver portion being formed of a resilient material whereby saidreceiver channel is normally closed; and means for enabling penetrationof said resilient material by the cannula with less force adjacent saidouter surface than adjacent said inner surface.
 8. A system according toclaim 7 wherein said enabling means includes a housing portion definedthrough a portion of said housing for receiving said receiver portion,said housing portion having a greater lateral extent adjacent said outersurface than adjacent said inner surface, said receiver channelextending between said inner and outer surfaces and normally sealingsaid housing portion between said flow channel and ambient atmosphere.9. A system according to claim 7, wherein said receiver portion has anupper portion and a lower portion, said upper portion being morecompliant than said lower portion whereby said upper portion ispenetrated by the cannula with the application of a lesser force theretothan that required to penetrate the lower portion.
 10. A system as inclaim 9, wherein said upper and lower portions of said receiver portionare defined by separately formed upper and lower receiver elements. 11.A system as in claim 9, wherein said upper receiver portion is formedfrom a material which is more compliant than a material from which saidlower receiver portion is formed.
 12. A system as in claim 9, whereinsaid upper receiver portion is thicker than said lower receiver portion.13. A system as in claim 9, in combination with an aspirator includingan axially extending cannula having a blunt distal tip, said cannulahaving a bore with first and second openings adjacent opposite endsthereof, said aspirator further including a receptacle in communicationwith said bore through said second opening thereof, said cannula beingadapted to be inserted into and through said receiver portion. 14.Apparatus for use with a blood aspiration system for sampling blood fromthe human body, comprising:an aspirator including an axially extendingcannula having a distal tip, said cannula having a bore with first andsecond openings adjacent opposite ends thereof, said aspirator furtherincluding a receptacle in communication with said bore through saidsecond opening thereof; an aspiration receiver forming part of the bloodaspiration system and including a housing having an outer surface and aninner surface and a flow channel for communication with the humanvasculature for flowing blood through the flow channel, said housinghaving a portion penetrable by said cannula to locate the first openingof said cannula in communication with said flow channel and enable bloodflow from said flow channel through said first opening, said bore andsaid second opening into said receptacle; said penetrable portionforming an opening upon penetration thereof with said cannula forreceiving said cannula, said penetrable portion being formed of aresilient material for sealing said opening upon withdrawal of saidcannula from said penetrable portion; and means for enabling penetrationof said resilient material by the cannula with less force adjacent saidouter surface than adjacent said inner surface.
 15. A system accordingto claim 14 wherein said enabling means includes a housing portiondefined through a portion of said housing for receiving said penetrableportion, said housing portion having a greater lateral extent adjacentsaid outer surface than adjacent said inner surface, said receivingportion extending between said inner and outer surfaces and normallysealing said housing portion between said flow channel and ambientatmosphere.
 16. A system according to claim 14, wherein said penetrableportion has an upper portion and a lower portion, said upper portionbeing more compliant than said lower portion whereby said upper portionis penetrated by the cannula with the application of a lesser forcethereto than that required to penetrate the lower portion.
 17. A systemas in claim 16, wherein said upper and lower portions of said receiverportion are defined by separately formed upper and lower receiverelements.
 18. A system as in claim 16, wherein said upper receiverportion is formed from a material which is more compliant than amaterial from which said lower receiver portion is formed.
 19. A systemas in claim 16, wherein said upper receiver portion is thicker than saidlower receiver portion.
 20. A system as in claim 14, wherein saidcannula has a blunt tip.
 21. Apparatus according to claim 14 whereinsaid penetrable portion has inner and outer surfaces and a centralrecess in said outer surface for initially locating said cannula tip forpenetration through said housing portion and disposition of said firstopening of said cannula in communication with said flow channel.
 22. Asystem as in claim 21, wherein said central recess has a greater lateralextent adjacent said outer surface than inwardly therefrom.
 23. In afluid delivery system for administration of fluid to a patient, thesystem being connected to a catheter having a bore for fluidcommunication with a blood vessel, the system including a connectionterminal, the improvement comprising:a receiver along said connectionterminal forming part of the fluid delivery system and including ahousing having a flow channel for communication with the humanvasculature for flowing fluid therethrough, said housing carrying areceiver portion penetrable by a cannula to place a bore of the cannulain communication with said flow channel; said receiver portion includinga receiver channel opened upon penetration thereof by the cannula, saidreceiver portion being formed of a resilient material; said receiverportion having an inner and outer surface interacting with the flowchannel and ambient atmosphere, respectively, said housing including afrustrum-shaped bore and including an inner end and an outer endadjacent said flow channel and ambient atmosphere, respectively, saidreceiver portion having a greater lateral dimension adjacent said innersurface than the lateral dimension of said bore adjacent said inner endso that said receiver portion adjacent said inner surface is compressedby said bore adjacent said inner end so that upon removal of saidcannula from said receiver channel, said receiver channel is tightlyclosed by said compression of said receiver portion so that fluid fromwithin said flow channel is prevented from leaking through said receiverchannel.
 24. The system of claim 23 wherein said receiver portion is aplug having a circular cross-section adjacent said inner surface. 25.The system of claim 24 wherein said housing bore has an apex adjacentsaid flow channel, said plug having an uncompressed diameter which isgreater than said housing bore apex.
 26. The system of claim 23 whereinsaid plug is comprised of silicone.
 27. A system according to claim 23,wherein said receiver portion has an upper portion and a lower portion,said upper portion being more compliant than said lower portion wherebysaid upper portion is penetrated by the cannula with the application ofa lesser force thereto than that required to penetrate the lowerportion.
 28. A system as in claim 27, wherein said upper and lowerportions of said receiver portion are defined by separately formed upperand lower receiver elements.
 29. A system as in claim 27, wherein saidupper receiver portion is formed from a material which is more compliantthan a material from which said lower receiver portion is formed.
 30. Asystem as in claim 27, wherein said upper receiver portion is thickerthan said lower receiver portion.
 31. A system as in claim 27, incombination with an aspirator including an axially extending cannulahaving a blunt distal tip, said cannula having a bore with first andsecond openings adjacent opposite ends thereof, said aspirator furtherincluding a receptacle in communication with said bore through saidsecond opening thereof, said cannula being adapted to be inserted intoand through said receiver portion.
 32. A medical system for the steriletransfer of fluid, through a cannula, between a fluid-filled chamber anda fluid receptacle comprising, a fluid-filled chamber defined by ahousing partially enclosing a receiver, said receiver including an upperreceiver portion and a lower receiver portion, said receiver beingcapable of receiving at least a portion of a cannula, said cannulaportion defining a displacement volume, said cannula expanding saidreceiver by compressing said receiver in response to the displacementvolume of said cannula portion when said cannula portion is insertedinto said receiver, said receiver being comprised of an elastic materialwhich is compressed to a greater extent in said lower receiver portion,and which resists compression by cannula insertion to define atransverse spring force against said cannula, said spring force beingless adjacent said upper receiver portion than adjacent said lowerportion, whereby said upper receiver is penetrated by said cannula withthe application of lesser force than is required to penetrate said lowerreceiver.
 33. The system of claim 32 wherein said upper receiver portionis more compliant than said lower receiver portion.
 34. The system ofclaim 33 wherein said upper receiver portion is formed from a materialwhich is more compliant than the material from which lower receiverportion is formed.
 35. The system of claim 33 wherein both said upperand lower portions are formed of silicone, said upper portion having alesser durometer than said lower portion.
 36. The system of claim 32further including circumferential side walls defining a bore having anaxis extending toward said chamber, said receiver being at leastpartially contained within said bore, said bore having a first endadjacent said chamber and a second end.
 37. The system of claim 36wherein said side walls define a transverse dimension of said bore, saidtransverse dimension being smaller adjacent said first end than adjacentsaid second end.
 38. The system of claim 37 wherein said side wallstaper inwardly from adjacent said second end toward adjacent said firstend so that said side walls define a frustrum-shaped bore.
 39. Thesystem of claim 38 wherein said receiver has a circular transversecross-section and wherein during manufacture said receiver is compressedwithin said frustrum-shaped bore so that the lower portion of saidreceiver is more transversely compressed by said tapered side walls thansaid upper portion of said receiver to form a frustrum-shaped receiver.40. The system of claim 36 wherein said side walls project away fromsaid housing.
 41. The system of claim 36 wherein said bore communicateswith said chamber through said first end, said receiver occluding saidbore.
 42. The system of claim 36 wherein said receiver is compressedinto said bore.
 43. A medical system for sterile transfer of fluidthrough a cannula between a fluid-filled container and a fluidreceptacle the system comprising:a fluid-filled container including ahousing defining a bore carrying an elastic receiver, said receiverdefining an axis and including an upper portion, a lower portion, and anopen axial perforation established by forcing the cannula through saidreceiver, said elastic receiver having an uncompressed frustrum shape,said receiver and said bore being sized and configured so that said borecompresses said receiver transversely to said axis to a greater extentalong said lower portion than along said upper portion when saidreceiver is installed within said bore, said compression of saidreceiver defining a transverse spring force along said perforation totightly seal said perforation.
 44. A medical system for sterile transferof fluid through a cannula between a fluid-filled container and a fluidreceptacle, the system comprising a fluid-filled container carrying anelastic receiver, said receiver defining an axis and including an upperportion, a lower portion, and an axial perforation extending throughsaid receiver, said system further including circumferential side wallsdefining a bore having an axis extending toward said chamber, said borehaving a first end adjacent said chamber and a second end and whereinsaid bore communicates with said chamber through said first end, saidside walls tapering inwardly from adjacent said second end towardadjacent said first end so that said side walls define a frustrum-shapedbore, said receiver being at least partially contained within said bore,said receiver occluding said bore, said receiver having a circulartransverse cross-section and wherein during manufacture said receiver iscompressed within said frustrum-shaped bore so that the lower portion ofsaid receiver is more transversely compressed by said tapered side wallsthan said upper portion of said receiver to form a compressedfrustrum-shaped receiver, the compression of said elastic receiver bysaid frustrum-shaped bore defining a transverse spring force along saidperforation to tightly seal said perforation, said spring force beinggreater along said lower portion than along said upper portion wherebysaid seal of said perforation is tighter along said lower portion thanalong said upper portion.
 45. In a fluid-filled extra-corporeal bloodaspiration system for sampling pressurized blood from the human body,the system being for connection to a catheter having a bore in fluidcommunication with a pressurized blood vessel, the system having meansfor elevating the fluid pressure above the pressure within said bloodvessel so that fluid flows from the system into the blood vessel and thesystem having means for reducing said fluid pressure below the pressurewithin said blood vessel so that blood flows from said blood vessel intosaid system, the improvement comprising:an aspirator receiver formingpart of the blood aspiration system and including a housing having aflow channel for communication with the human vasculature for flowingblood therethrough, said housing carrying a receiver portion penetrableby a cannula to place a bore of the cannula in communication with saidflow channel and to allow sampling of blood; said receiver portion beingpreperforated to form a receiver channel for receiving the cannula uponpenetration thereof by the cannula, said receiver portion being formedof a resilient material whereby said receiver channel is normallyclosed; said receiver portion having an upper portion and a lowerportion defined by separately formed upper and lower receiver elements,said upper portion being more compliant than said lower portion wherebysaid upper portion is penetrated by the cannula with the application ofa lesser force thereto than that required to penetrate the lowerportion.
 46. In a fluid-filled extra-corporeal blood aspiration systemfor sampling pressurized blood from the human body, the system being forconnection to a catheter having a bore in fluid communication with apressurized blood vessel, the system having means for elevating thefluid pressure above the pressure within said blood vessel so that fluidflows from the system into the blood vessel and the system having meansfor reducing said fluid pressure below the pressure within said bloodvessel so that blood flows from said blood vessel into said system, theimprovement comprising:an aspirator receiver forming part of the bloodaspiration system and including a housing having a flow channel forcommunication with the human vasculature for flowing blood therethrough,said housing carrying a receiver portion penetrable by a cannula toplace a bore of the cannula in communication with said flow channel andto allow sampling of blood; said receiver portion being preperforated toform a receiver channel for receiving the cannula upon penetrationthereof by the cannula, said receiver portion being formed of aresilient material whereby said receiver channel is normally closed;said receiver portion having an upper portion and a lower portiondefined by separately formed upper and lower receiver elements, saidupper receiver portion being formed from a material which is morecompliant than a material from which said lower receiver portion isformed, whereby said upper portion is penetrated by the cannula with theapplication of a lesser force thereto than that required to penetratethe lower portion.
 47. In a fluid-filled extra-corporeal bloodaspiration system for sampling pressurized blood from the human body,the system being for connection to a catheter having a bore in fluidcommunication with a pressurized blood vessel, the system having meansfor elevating the fluid pressure above the pressure within said bloodvessel so that fluid flows from the system into the blood vessel and thesystem having means for reducing said fluid pressure below the pressurewithin said blood vessel so that blood flows from said blood vessel intosaid system, the improvement comprising:an aspirator receiver formingpart of the blood aspiration system and including a housing having aflow channel for communication with the human vasculature for flowingblood therethrough, said housing carrying a receiver portion penetrableby a cannula to place a bore of the cannula in communication with saidflow channel and to allow sampling of blood; said receiver portion beingpreperforated to form a receiver channel for receiving the cannula uponpenetration thereof by the cannula, said receiver portion being formedof a resilient material whereby said receiver channel is normallyclosed; said receiver portion having an upper portion and a lowerportion defined by separately formed upper and lower receiver elements,said upper portion being more compliant than said lower portion wherebysaid upper portion is penetrated by the cannula with the application ofa lesser force thereto than that required to penetrate the lowerportion; said receiver portion having inner and outer surfaces,interfacing with the flow channel and ambient atmosphere, respectively,said receiver channel extending between said inner and outer surfacesand normally sealing said housing receiver portion between said flowchannel and ambient atmosphere so that blood flowing through said flowchannel is in direct contact with said receiver channel; said receiverportion further having a central recess in said outer surface adjacentsaid receiver channel for initially receiving the distal tip of saidcannula and locating said cannula for penetration through said receiverchannel in said housing portion and disposition of said bore of saidcannula in communication with said flow channel; said flow channel beinggenerally cylindrical in shape, the inner surface of said receiverportion forming part of said flow channel having an arcuate segmentforming a portion of the generally cylindrical shape of said flowchannel.
 48. In a fluid-filled extra-corporeal blood aspiration systemfor sampling pressurized blood from the human body, the system being forconnection to a catheter having a bore in fluid communication with apressurized blood vessel, the system having means for elevating thefluid pressure above the pressure within said blood vessel so that fluidflows from the system into the blood vessel and the system having meansfor reducing said fluid pressure below the pressure within said bloodvessel so that blood flows from said blood vessel into said system, theimprovement comprising:an aspirator receiver forming part of the bloodaspiration system and including a housing having an outer surface and aninner surface and having a flow channel for communication with the humanvasculature for flowing blood therethrough, said housing carrying areceiver portion penetrable by a cannula to place a bore of the cannulain communication with said flow channel and to allow sampling of blood;said receiver portion being preperforated to form a receiver channel forreceiving the cannula upon penetration thereof by the cannula, saidreceiver portion being formed of a resilient material whereby saidreceiver channel is normally closed; and means for enabling penetrationof said resilient material by the cannula with less force adjacent saidouter surface than adjacent said inner surface; said receiver portionhaving an upper portion and a lower portion defined by separately formedupper and lower receiver elements, said upper portion being morecompliant than said lower portion whereby said upper portion ispenetrated by the cannula with the application of a lesser force theretothan that required to penetrate the lower portion.
 49. In a fluid-filledextra-corporeal blood aspiration system for sampling pressurized bloodfrom the human body, the system being for connection to a catheterhaving a bore in fluid communication with a pressurized blood vessel,the system having means for elevating the fluid pressure above thepressure within said blood vessel so that fluid flows from the systeminto the blood vessel and the system having means for reducing saidfluid pressure below the pressure within said blood vessel so that bloodflows from said blood vessel into said system, the improvementcomprising:an aspirator receiver forming part of the blood aspirationsystem and including a housing having an outer surface and an innersurface and having a flow channel for communication with the humanvasculature for flowing blood therethrough, said housing carrying areceiver portion penetrable by a cannula to place a bore of the cannulain communication with said flow channel and to allow sampling of blood;said receiver portion being preperforated to form a receiver channel forreceiving the cannula upon penetration thereof by the cannula, saidreceiver portion being formed of a resilient material whereby saidreceiver channel is normally closed; and means for enabling penetrationof said resilient material by the cannula with less force adjacent saidouter surface than adjacent said inner surface; wherein said receiverportion has an upper portion and a lower portion, said upper receiverportion is formed from a material which is more compliant than amaterial from which said lower receiver portion is formed, whereby saidupper portion is penetrated by the cannula with the application of alesser force thereto than that required to penetrate the lower portion.50. Apparatus for use with a blood aspiration system for sampling bloodfrom the human body, comprising:an aspirator including an axiallyextending cannula having a distal tip, said cannula having a bore withfirst and second openings adjacent opposite ends thereof, said aspiratorfurther including a receptacle in communication with said bore throughsaid second opening thereof; an aspiration receiver forming part of theblood aspiration system and including a housing having an outer surfaceand an inner surface and a flow channel for communication with the humanvasculature for flowing blood through the flow channel, said housinghaving a portion penetrable by said cannula to locate the first openingof said cannula in communication with said flow channel and enable bloodflow from said flow channel through said first opening, said bore andsaid second opening into said receptacle; said penetrable portionforming an opening upon penetration thereof with said cannula forreceiving said cannula, said penetrable portion being formed of aresilient material for sealing said opening upon withdrawal of saidcannula from said penetrable portion; and means for enabling penetrationof said resilient material by the cannula with less force adjacent saidouter surface than adjacent said inner surface; wherein said penetrableportion has an upper portion and a lower portion defined by separatelyformed upper and lower receiver elements, said upper portion being morecompliant than said lower portion whereby said upper portion ispenetrated by the cannula with the application of a lesser force theretothan that required to penetrate the lower portion.
 51. Apparatus for usewith a blood aspiration system for sampling blood from the human body,comprising:an aspirator including an axially extending cannula having adistal tip, said cannula having a bore with first and second openingsadjacent opposite ends thereof, said aspirator further including areceptacle in communication with said bore through said second openingthereof; an aspiration receiver forming part of the blood aspirationsystem and including a housing having an outer surface and an innersurface and a flow channel for communication with the human vasculaturefor flowing blood through the flow channel, said housing having aportion penetrable by said cannula to locate the first opening of saidcannula in communication with said flow channel and enable blood flowfrom said flow channel through said first opening, said bore and saidsecond opening into said receptacle; said penetrable portion forming anopening upon penetration thereof with said cannula for receiving saidcannula, said penetrable portion being formed of a resilient materialfor sealing said opening upon withdrawal of said cannula from saidpenetrable portion; and means for enabling penetration of said resilientmaterial by the cannula with less force adjacent said outer surface thanadjacent said inner surface; wherein said penetrable portion has anupper portion and a lower portion, said upper receiver portion is formedfrom a material which is more compliant than a material from which saidlower receiver portion is formed, whereby said upper portion ispenetrated by the cannula with the application of a lesser force theretothan that required to penetrate the lower portion.
 52. In a fluiddelivery system for administration of fluid to a patient, the systembeing connected to a catheter having a bore in fluid communication witha blood vessel, the system including a connection terminal, theimprovements comprising:a receiver along said connection terminalforming part of the fluid delivery system and including a housing havinga flow channel for communication with the human vasculature for flowingfluid therethrough, said housing carrying a receiver portion penetrableby said cannula to place a bore of the cannula in communication withsaid flow channel; said receiver portion being preperforated to form areceiver channel for receiving the cannula upon penetration thereof bythe cannula, said receiver portion being formed of a resilient materialwhereby said receiver channel is normally closed; and means for enablingpenetration of said resilient material by the cannula with less forceadjacent said outer surface than adjacent said inner surface; whereinsaid receiver portion has an upper portion and a lower portion definedby separately formed upper and lower receiver elements, said upperportion being more compliant than said lower portion whereby said upperportion is penetrated by the cannula with the application of a lesserforce thereto than that required to penetrate the lower portion.
 53. Amedical system for sterile transfer of fluid through a cannula andbetween a fluid-filled chamber and a fluid receptacle, said systemcomprising a fluid-filled chamber being defined by a housing andcarrying a receiver, said receiver including an upper portion and alower portion and an axial perforation extending through said receiver,said perforation being capable of receiving at least a portion of saidcannula, said cannula portion defining a displacement volume, saidcannula expanding said perforation by compressing said receiver inresponse to the displacement volume of said cannula portion when saidcannula portion is inserted into said perforation, said receiverresisting said compression to define a transverse spring force againstsaid cannula, said upper receiver portion being formed from a materialwhich is more compliant than the material from which lower receiverportion is formed said spring force is less adjacent said upper portionthan adjacent said lower portion, whereby the outer portion of saidreceiver is penetrated by said cannula with the application of lesserforce than is required to penetrate the inner portion thereof.
 54. Amedical system for sterile transfer of fluid through a cannula andbetween a fluid-filled chamber and a fluid receptacle, said systemcomprising a fluid-filled chamber being defined by a housing andcarrying a receiver, said receiver including an upper portion and alower portion and an axial perforation extending through said receiver,said perforation being capable of receiving at least a portion of saidcannula, said cannula portion defining a displacement volume, saidcannula expanding said perforation by compressing said receiver inresponse to the displacement volume of said cannula portion when saidcannula portion is inserted into said perforation, said receiverresisting said compression to define a transverse spring force againstsaid cannula, said upper and lower receiver portions being formed fromsilicone with said upper receiver portion being more compliant andhaving a lesser durometer than said lower receiver portion so that saidspring force is less adjacent said upper portion than adjacent saidlower portion, whereby the outer portion of said receiver is penetratedby said cannula with the application of lesser force than is required topenetrate the inner portion thereof.